The Miami area continues to be ground zero for Medicare fraud, the Justice Department said in announcing the
latest round of indictments obtained by the government’s anti-fraud taskforces.
Justice accused 89 individuals in eight metropolitan areas of fraudulently billing Medicare for approximately $223 million. The Miami area accounted for about a third of the individuals charged and $45 million of the allegedly illegal claims, the May 14 Justice announcement states.
Among the South Florida cases:
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Five defendants are charged with receiving kickbacks that involved two home health agencies – Caring Nurse Home Health, Corp. and Good Quality Home Health. The five allegedly supplied patients to Caring Nurse and/or Good Quality in exchange for kickbacks and bribes, Justice says. The two agencies, in turn, fraudulently billed Medicare for approximately $50 million for home health services “that were not provided and/or were not medically necessary.”
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Two defendants accused of participating in a scheme involving Lord’s Medical & Rehab Center, Inc. (Lords), a medical clinic that purportedly provided Medicare Advantage beneficiaries with medical items and services. Between February 2010 and July 2011, the defendants allegedly caused the clinic to submit approximately $5.5 million in false claims for such items and services and actually received about $2.2 million.
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A nurse and two patient recruiters charged with health care fraud for their alleged roles in “a massive health care fraud scheme involving Ideal Home Health,” which submitted more than $40 million in fraudulent claims to Medicare. While working for Ideal, the nurse “falsified patient visitation logs to reflect that home health care nursing services had been provided to beneficiaries when such services had, in fact, not been provided,” Justice says. The two recruiters received payments for providing Ideal and other home health agencies with beneficiaries that the agencies later used to bill the Medicare program, according to Justice.